12-0870 (RPL)P.O. BOX 1504
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
•tt 4 4 "
BUILDING & SAFETY DEPARTMENT
BUILDING PERMIT
Application Number:t 12-0 0 00 0870
Property Address: 81479 GOLDEN POPPY WY
APN: 764-280-999-123 -300236-
Application description: POOL - RESIDENTIAL
Property Zoning: MEDIUM HIGH DENSITY RES
Application valuation: 28000
Applicant: Architect or Engineer:
p
UC CO
NTRATR'S DECLARATION
I hereby ajfirmiunder penalty of perjury that I icensed under provisions of Chapter 9 (commencing with
Section 7 lei f of Division 3 of the Businepe-atAFrotessionals Code, and my License is in full force and effect.
Lice C,53/ License No.: 658996
DDtate: 'v ntractor: .
OWNER -BUILDER DECLARATION
nalty of perjury that I xempt from the Contractor's State License Law for the
I hereb aff m under pe
following reason (Sec. 7031.5, Business and P essions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair an structure, prior to its issuance, also requires -the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
1 _ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the -
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.).
(_ 1 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractorls) licensed
pursuant to the Contractors' State License Law.). '
I _ 1 I am exempt under Sec. , BAP.C. for this reason
Date: Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
Owner:
DARRELL SCHUETZLE
81479 GOLDEN POPPY
LA QUINTA, CA 92253
Contractor:
FAMILY POOLS CONST
P O BOX 283
LA QUINTA, CA 9224
(760)564-3655
Lic. No.: 658996
VOICE (760) 777-7012
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
Date: 8/03/12
Li
AUG 20?2 I
OF LA QUINTA
------------------
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
Y I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for wh' this permit is issued. My workers' compensation
insurance carrier and policy number are .
Carrier STATE FUND P ylumber 1344032-2012
_ I certify that, in the performs
Wthe work for which this permit is issued, I shall not employ any
person in any manners
t become subject to the workers' compensation laws of California,
and agree that, if I sho
3700 of the L or C , I
t plicant:
ome subject to the workers' compensation provisions of Section
forthwi comply with those provisions.
WAR IN FAILURE TO SECURE WORK
'COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUB ECT AN EMPLOYER TO CRIMINAL
LTIES AND CIVIL FINES UP TO ONE HUNDRED -THOUSAND
DOLLARS ($100,000). IN ADDITION Tot
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose reques d for
whose benefit work is performed under or pursuant to any permit issued t of this application,
the owner, and the applicant, each agrees to, and shall defend, Inde a u and hold harmless the City
of La Quinta, its officers, agents and employees for any act or fission related to the work being
performed under or following issuance of this per
2. Any permit issued as a result of this application ec s null and void if work is not commenced
within 180 days from date of issuance of suc rm t, or cessation of work for 180 days will subject
permit to cancellation.
I certify that 1 have read this application and state that a bov information is correct. I agree to comply with all
city an co y ordinances and state laws relating to bui c truction, and hereby authorize representatives
40fWenter
he above-mentioned grope y tion purposes.
(Applicant or Agent):
I
LQPERMIT
Application Number . . . . . 12-00000870
Permit . . . BLDG POOL PERMIT
Additional desc .
Permit Fee . . . . 271.50 Plan Check Fee 176.48
Issue Date . . . . Valuation 28000
Expiration Date 1/30/13
Qty Unit Charge Per Extension
BASE FEE 252.00
3.00 6.5000 THOU BLDG 25,001-50,000 19.50
----------------------------------------------------------------------------
Permit . . . MECH POOL
Additional desc .
Permit Fee . . . . 26.00 Plan Check Fee 6.50'
Issue Date . . . . Valuation 0
Expiration Date 1/30/13
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 11.0000 EA MECH FURNACE >100K 11.00
Permit . . . ELEC POOL PERMIT -RES
Additional desc .
Permit Fee . . 45.00 Plan Check Fee 11.25
Issue Date Valuation . . . . 0
Expiration Date 1/30/13
Qty Unit Charge Per Extension
BASE FEE 15.00
1.00 30.0000 EA ELEC PRIVATE SWIMMING POOL 30.00
----------------------------------------------------------------------------
Permit . . . PLUMBING
Additional desc .
Permit Fee . . . . 33.00 Plan Check Fee 8.25
Issue Date . . . . Valuation . . . . 0
Expiration Date 1/30/13
Qty Unit Charge Per Extension
BASE FEE 15.0.0
2.00 .6.0000 EA PLB FIXTURE 12.00
1.00 3.0000 EA PLB WATER INST/ALT/REP 3.00
1.00 3.0000 EA PLB GAS PIPE 1-4 OUTLETS 3.00
----------------------------------------------------------------------------
Special Notes and Comments
.POOL/SPA, FIREPIT & GAS LINE FOR
Application Number . . . . . .12-00000870
----------------------------------------------------------------------------
Special Notes and Comments
FIREPIT. ALARMS/BARRIERS SHALL BE
IN
PLACE AT PRE -PLASTER INSPECTION.
EQUIPMENT ENCLOSURE NOT INCLUDED.
2010
CODES.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . BLDG STDS ADMIN (SB1473)
2.00
Fee summary Charged
----------
Paid
Credited
--------------------
Due
---------------------------
Permit Fee Total 375.50
.00
.00
375'.50
Plan Check Total 202.48
.00
.00
202.48
Other.Fee Total 2.00
.00
.00
2.00
Grand Total 579.98
.00
.00
579.98
LQPERMIT
14'-6"
Existing
G Wall
7'-6"
. o
•E
G' Wall
4'
75pa, + 18°
25'-6" —
Gas for + 15"
Fire Pit
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
DATEL*IZ- gY+
DARRELL 5CH U ETZLE
81479 Golden Poppy Way
Trilogy Country Club
Quinta
0
I/8"= 1'
0
Construction
P0015 Spas Fountaln5
(760) 5 64-3 6 5 5
Lic. #658996
Bin #
City of La Quinta
Building 8z Safety Division
P.O. Box 1504, 78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #D
Project Address: 7 FT 7- 71
Owner's Name:
A. P. Number.
Address: 02po
Legal Description:
City, ST, Zip: 7j
Contractor: ),
Telephone:
/�d
Address: , (Ji r 93
Project Description:
City, ST, Zip:
r 't %fii.� Sx.`l�y�:..''�yf�•�y\vY;i��r'!�:
Telephon
State Lic. # : City Lic. #;
Arch., Engr., Designer.
Address:
City., ST, Zip:
Telephone:
Construction Type: Occupancy:
Project type (circle one): New Add'n Alter Repair Demo
State Lic. #:
Name of Contact Person: 1'
Sq. Ft:
#Stories:
# Units:
Telephone # of Contact Person:
Estimated Value of Project t
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
3
Item
Amount
Structural Cafes.
Reviewed, ready for corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Tide 24 Catcs.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan, 1
2°° Review, ready for corrections/issue
Electrical
Subcontactor,J -st
Called Contact Person
Plumbing
Grant Deed
Plans picked up
S-M.L
H.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"' Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees
Total Permit Fees